Stroke: 0.6mg/kg Atipenase is better for DWI-Flair mismatches to unknown onset time?

!---- Recently, the WAKE-UP trial has shown that 0.9 mg/kg atepase is effective and safe for acute ischemic stroke, which is not known for the duration of onset, if there is a mismatch between DWI and Flairin Japan, acute ischemic stroke patients used another dose (0.6 mg/kg) of atepastoe based on one-arm tests, observational studies and guidelinesENCHANTED trial showed that although the test did not reach the primary endpoint of non-inefficiencies, the efficacy difference seq.9 and 0.6 mg/kg atepase were small, and the overall results were similar after equilibrium effectiveness and safetyPublished the results of the THAWS trial in Stroke magazine in April 2020 by Masatoshi Koga from Japan, with the aim of evaluating the effectiveness and safety of 0.6mg/kg atepase to patients with unknown onset and Flair-negative acute strokethawS trials led researchers to initiate, multicenter, randomized, open-label, and blind-end control trialspatients aged 20 who eventually looked normal at a time of 4.5h and when symptoms were detected were less than 4.5h, or at an unknown age of 20 years of ageMay 2014, the researchers revised the final seemingly normal time limit to 12h and August 2015 to no time limit (matching the WAKE-UP trial)light stroke NIHSS?lt;5 points (changed to .lt;2 points in August 2015) or severe stroke NIHSS?gt;25 points were excluded from the trial, unlike the WAKE-UP trial (NIHSS score is not limited)in addition, patients must comply with the inclusion criteria of the ateppoenase standard,if the DWI finds an abnormal signal and Flair does not have a noticeable signal change, there is this mismatch (negative Flair mode) at randomthe main exclusion criteria: the presence of a taboo for MRI examination (e.gpacemaker), planned or expected surgical or intravascular reperfusion therapy, pregnancy, lactation, or possible pregnancy or life expectancy, intracranial bleeding, ASPECTS score of 4 or visual lesions volume more than 50% of the MCA or PCA vascular distribution area, more than half of the brain stem or half of the brain hemispherethese patients were randomly treated with 0.6 mg/kg ataprese venous thrombolytic therapy or standard internal medicine treatment at a ratio of 1:1the main end point of theis 90 days mRS0-1with the premature cessation of wake-up calls and positive results in the WAKE-UP trial, which included 131 patients and terminated the trial early (planned 300), of which 55 were women, with an average age of 74.4 yearsthe ratio of adip enzyme (32/68, 47.1%) and control group (28/58, 48.3%; relative risk , 0.97 , 95% CI, 0.68-1.41 ) ;P to 0.892) The incidence of symptomatic intracranial haemorrhage in 22 to 36 hours was 1/71 and 0/60 (RR, Infinity (95% CI, 0.06-Infinity) ;P.999) The incidence of 90 days of death was 2/71 and 2/60 (RR, 0.85 (95% CI, 0.06-12.58) ;P .999) the final authors, there was no difference in the proportion of good prognosis between the atepsoenzyme group and the control group in ischemic stroke patients with unknown onset time 0.6 mg/kg atipase is as safe as standard treatments early termination of the trial hinders the conclusive outcome .